Abstract
The Exercise is Medicine Canada (EIMC) initiative promotes physical activity counselling and exercise prescription within health care. The purpose of this study was to evaluate perceptions and practices around physical activity counselling and exercise prescription in health care professionals before and after EIMC training. Prior to and directly following EIMC workshops, 209 participants (physicians (n = 113); allied health professionals (AHPs) (n = 54), including primarily nurses (n = 36) and others; and exercise professionals (EPs) (n = 23), including kinesiologists (n = 16), physiotherapists (n = 5), and personal trainers (n = 2)) from 7 provinces completed self-reflection questionnaires. Compared with AHPs, physicians saw more patients (78% > 15 patients/day vs 93% < 15 patients/day; p < 0.001) and reported lower frequencies of exercise counselling during routine client encounters (48% vs 72% in most sessions; p < 0.001). EPs had higher confidence providing physical activity information (92 ± 11%) compared with both physicians (52 ± 25%; p < 0.001) and AHPs (56 ± 24%; p < 0.001). Physicians indicated that they experienced greater difficulty including physical activity and exercise counselling into sessions (2.74 ± 0.71, out of 5) compared with AHPs (2.17 ± 0.94; p = 0.001) and EPs (1.43 ± 0.66; p < 0.001). Physicians rated the most impactful barriers to exercise prescription as lack of patient interest (2.77 ± 0.85 out of 4), resources (2.65 ± 0.82 out of 4), and time (2.62 ± 0.71 out of 4). The majority of physicians (85%) provided a written prescription for exercise in <10% of appointments. Following the workshop, 87% of physician attendees proposed at least one change to practice; 47% intended on changing their practice by prescribing exercise routinely, and 33% planned on increasing physical activity and exercise counselling, measured through open-ended responses.
Highlights
Physical inactivity is a primary component of chronic disease risk, and is estimated to cause 6%–10% of major noncommunicable diseases worldwide (Lee et al 2012)
Demographics Participants were split into 3 distinct groups including: physicians (n = 113) comprised of family physicians (n = 103) and specialist physicians (n = 10); allied health professionals (AHPs) (n = 54) comprised of registered nurses (n = 26), nurses (n = 7), social workers (n = 4), nurse practitioners (n = 3), and other health care providers (n = 11); and exercise professionals (EPs) (n = 23) comprised of kinesiologists (n = 16), physiotherapists (n = 5), and personal trainers (n = 2)
The purpose of this study was to evaluate perceptions and practices around physical activity counselling and exercise prescription in health care professionals before and after Exercise is Medicine Canada (EIMC) training. The results of this analysis clearly demonstrate that physicians and AHPs have lower confidence for physical activity counselling and prescribe exercise far less in their regular clinical practice than EPs do
Summary
Physical inactivity is a primary component of chronic disease risk, and is estimated to cause 6%–10% of major noncommunicable diseases worldwide (Lee et al 2012). Canada’s physical activity guidelines recommend 150 min of moderate to vigorous aerobic physical activity per week in bouts of 10 min or more combined with 2 days of engaging in muscle and bone strengthening exercises to achieve health benefits (Tremblay et al 2011). Despite the benefits of being physically active, only 15% of Canadian adults achieve aerobic physical activity guidelines when measured objectively using accelerometry (Colley et al 2011). This lack of physical activity and associated increase in sedentary behaviour likely accounts for a majority of the decrease in physical fitness of Canadians, compared with 30 years ago (Shields et al 2010).
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